An estimated 8.9 million Americans live at the severe end of the spectrum of alcohol use disorders. Regardless of terminology – alcohol addiction, alcohol dependence, or moderate to severe alcohol use disorder – these individuals satisfy diagnostic criteria for a potentially fatal chronic disease characterized by high post-treatment recidivism. The human and dollar costs of this situation are enormous and touch everyone; yet the magnitude of our collective response fails to match the magnitude of the problem. Continue reading →

People who are close to individuals with active addiction sometimes have to make high-stakes decisions. Desperate situations compel them to act, and then leave them hoping and praying for a positive outcome. Parents’ decisions may be the toughest, regardless of the age of their child. “Will giving support right now save my child—or be enabling and ultimately destructive?” “Will withholding support right now save my child—or precipitate disaster?”Continue reading →

In addition to their literal definitions, the words we use can invoke powerful ideas and feelings. The extended cognitive and emotional meanings of words are their connotations. Words, particularly their connotations, help shape sense of self and expectations, which makes it important to choose words carefully when characterizing others and ourselves. Affirmations enrich sense of self and set favorable expectations. Pejorative language and labels, on the other hand, feed stigma and generate harmful self-fulfilling prophecies.Continue reading →

Ever wonder why so many of us lose our voice precisely at the moment we need to ask for help? Credit shame, the pivotal emotion that drives self-defeating behavior, together with all-or-nothing thinking, our most common cognitive distortion.

Educators and clinicians have long recognized that children and youth with social, emotional, and learning problems often experience neglect and abuse in earlier years. Research now shows that harm associated with traumatic childhood experiences does not end when young people grow up.

After alcohol and marijuana, what mood altering substance is the next most popular among U.S. high school students? You might reasonably suspect prescription pain relievers or prescription stimulants. But in a 2012 survey of drug use in the past year by 9th to 12th graders, synthetic marijuana took third place.

Approximately 100 million Americans suffer from chronic pain. Nationwide, chronic pain causes more disability than cancer and heart disease combined, and costs $550 million annually in lost workdays. Continue reading →

Ask people engaged in addiction treatment for a single word to describe where they just came from—a word that sums up the experience of active addiction—and they quickly agree on “hell.”

Many years ago someone asked the then famous and now controversial evangelist Billy Sunday, “What must I do to go to hell?” Sunday replied, “Nothing.” In other words, make no effort; you will get there. Beliefs about religion and an afterlife aside, Sunday’s answer speaks to people who want to get free from active addiction: make no effort; do what comes naturally; and you will keep returning to hell.

In the United States, an estimated 20 million people have problems with alcohol or other drugs. Many of these individuals attempt to get sober, but remain stuck using addictive substances because they try to fix things their own way—and berate themselves when nothing changes—unaware they are working against the laws of nature. Much like drivers who hit the gas but go nowhere when their car is stuck in snow, they keep using alcohol and other drugs because they don’t understand why they are stuck or how to work with the laws of nature—laws that govern human behavior, addiction, and recovery from addiction—to cope with their problems.

Behavior is everything we can observe an organism do. Examples of human behavior include talking, eating, driving, dancing, breathing, and body language. Human behavior originates in the central nervous system, which consists of the brain and spinal cord.

People in the United States don’t shrink from passionate expressions of opposing views. Whigs vs. Tories, Republicans vs. Democrats, and Red Sox fans vs. Yankees fans are just a few cases in point. People’s views on marijuana are no less passionate and no less polarized. During treatment for addiction to opioids a man in his early twenties said, “Marijuana is an herb; it’s natural. It relaxes me; I’m not addicted to it; and I’m going to smoke it when I get out of here.” In the same room, a man in his early thirties also in treatment for addiction to opioids said, “People disagree whether marijuana is a gateway drug. It is for me. If I never smoked marijuana I never would have gotten hooked on harder drugs. And if I hadn’t tried to smoke it again after my first treatment, I wouldn’t be here right now.”

Too often society is unfair to people with addiction—a fact that disturbs most people with active addiction, most people who are recovering from addiction, and most people who advocate for those groups. Fortunately we can do something about it. Don’t be daunted—small steps can have a powerful impact. Continue reading →

This series has advocated that society make disease prevention a priority—especially the prevention of substance use disorders—while recognizing that the prevention of substance use disorders (SUDs) is already a priority for some providers and agencies. Before organizers of SUD prevention services present an intervention to a target population, they like to be confident that their efforts will result in healthy change. Also, before funding sources contribute to SUD prevention services, they like to be confident that their investment will produce worthwhile results. For both these reasons, organizers of SUD prevention services prefer to deliver prevention approaches that are evidence-based. That is, organizers like to replicate programs that were shown to be effective when they were presented before. Continue reading →